Psychological therapy for schizophrenia Flashcards
Who does family therapy for schizophrenia take place with?
Families as well as the identified patient
Identified patient
A term used in family therapy which describes one member of a dysfunctional family who expresses the family conflicts
What does family therapy aim to do?
Improve the quality of communication and interaction between family members
True/False: There is a range of approaches in family therapy for schizophrenia
True
There is a range of approaches in family therapy for schizophrenia, in keeping with psychological theories like…
the double-bind and schizophrenogenic mother
Pharoah et al. (2010) identified a range of strategies that family therapists use to do what?
Improve the functioning of a family that has a member with schizophrenia
Family therapy aims to reduce levels of ________/_________ emotion
negative/expressed
True/False: Family therapy aims to reduce the level of emotion generally
True
Family therapy aims to reduce the level of emotion generally but especially which emotions?
Negative emotions such as anger and guilt
Why is reducing stress important in family therapy for schizophrenia?
Important to reduce the likelihood of relapse
Which emotions create stress in someone with schizophrenia?
Anger and guilt
During family therapy for schizophrenia, what does the therapist encourage that family members form?
A therapeutic alliance
During family therapy for schizophrenia the therapist encourages family members to form a therapeutic alliance so family members what?
Agree on the aims and therapy
Family therapy tries to improve the families’ beliefs about the _________ towards schizophrenia
behaviour
An aim of family therapy is to ensure that family members can achieve what between caring for the individual with schizophrenia and managing their own lives?
A balance
An aim of family therapy is to ensure that family members can achieve a balance between what?
Caring for the individual with schizophrenia and managing their own lives
What did Burbach (2018) propose?
A model for working with families dealing with schizophrenia
Burbach (2018)’s model begins with what?
Sharing basic information and providing emotional and practical support
How many phases are there in Burbach (2018)’s model for family therapy?
7
What does phase 2 of Burbach (2018)’s model for family therapy involve?
Identifying resources including what different family members can and cannot offer
What does phase 3 of Burbach (2018)’s model for family therapy aim to do?
Encourage mutual understanding, creating a safe space for all family members to express their feelings
What does phase 4 of Burbach (2018)’s model for family therapy involve?
Identifying unhelpful patterns of interaction
What is phase 5 of Burbach (2018)’s model for family therapy about?
Skills training such as learning stress management techniques
What does phase 6 of Burbach (2018)’s model for family therapy look at?
Relapse prevention planning
What is phase 7 of Burbach (2018)’s model for family therapy?
Maintenance for the future
True/False: There is evidence of the effectiveness of family therapy for schizophrenia
True
What did McFarlane’s 2016 review of studies condlude?
That family therapy was one of the most consistently effective treatments available for schizophrenia
McFarlane found in particular that _______ rates were reduced after family therapy
relapse
McFarlane found that family therapy for schizophrenia reduced relapse rates typically by __-__%
50-60
McFarlane (2016) concluded what about family therapy?
Using it as mental health initially starts to decline is particularly promising
What does clinical advice from NICE recommend for everyone with a diagnosis of schizophrenia?
Family therapy
McFarlane (2016)’s findings mean that family therapy is likely to be of benefit to people with what?
Both early and ‘full-blown’ schizophrenia
True/False: Family therapy for schizophrenia is just for the benefit of the identified patient
False, it is also for the families that provide the bulk of care
Who benefits from family therapy for schizophrenia?
All family members
What did Lobban and Barrowclough conclude about the benefits of family therapy for schizophrenia being for all family members?
These effects are important because families provide the bulk of care for people with schizophrenia - by strengthening the functioning of a whole family, family therapy lessens the negative impact of schizophrenia on other family members
Lobban and Barrowclough said that by strengthening the functioning of a whole family, family therapy lessens the impact of what?
Schizophrenia on other family members
Who provides the bulk of care for people with schizophrenia?
Families
Family therapy strengthens the ability of the family to do what for the person with schizophrenia?
Support them
True/False: Family therapy for schizophrenia has wider benefits beyond the obvious positive impact on the identified patient
True
How does family therapy for schizophrenia have huge economic benefits?
It reduces relapse rates and makes families better able to provide the bulk of care - the state doesn’t need to pay as much
Family therapy has very significant ___________ benefits for people with schizophrenia and their families
therapeutic
CBT to treat schizophrenia usually takes place over a period of _-__ sessions
5-20
CBT for schizophrenia takes longer/less than other conditions
longer
True/False: CBT for schizophrenia can be done in groups
True
What does CBT aim to deal with?
Both thoughts (cognitions) and behaviour
CBT can help a client make sense of how their __________ __________ impact their feelings and behaviour
irrational cognitions
CBT can help a client make sense of how irrational cognitions impact their what?
feelings and behaviour
Give an example of irrational cognitions
Any from delusions and hallucinations
Understanding where symptoms of schizophrenia come from can be hugely helpful for those with symptoms such as a_______ ______________
auditory hallucinations
If a client hears voices and believes the voices represent demonic forces, they will naturally be very what?
Afraid
If a therapist can convince someone with schizophrenia that the their auditory hallucinations actually come from…, this is much less frightening and hence less debilitating
the malfunctioning speech centre in their own brain and it cannot hurt them if they ignore it
If a therapist can convince someone with schizophrenia that the their auditory hallucinations actually come from the malfunctioning speech centre in their own brain and it cannot hurt them if they ignore it, what impact will this have?
This is much less frightening and hence debilitating
True/False: CBT eliminates symptoms of schizophrenia
False, it doesn’t eliminate them but can make people better able to cope with them
The fact that CBT makes people better able to cope with schizophrenia in turn reduces what and improves what?
Reduces their distress, improves their ability to function adequately
Teaching people with schizophrenia that voice-hearing is an extension of the ordinary experience of thinking in words is an example of what?
Normalisation
How can delusions be challenged?
A process of reality testing
When delusions are challenged through a process of reality testing, the person with schizophrenia and their therapist jointly…
examine the likelihood that beliefs are true
True/False: In some cases where delusions are resistant to reality testing CBT can still be used to tackle the anxiety and depression that result from living with schizophrenia
True
Turkington et al. (2004) describes an example of CBT used to challenge which ideas?
Where a paranoid client’s delusions come from
Jauhar et al. (2014) reviewed __ studies of using CBT with schizophrenia, concluding that there is clear evidence for small but significant effects
34
Jauhar et al. (2014) reviewed 34 studies of using CBT with schizophrenia and concluded what?
That there is clear evidence for small significant effects
Jauhar et al. (2014) concluded that there is clear evidence for small but significant effects of CBT on which symptoms of schizophrenia?
Positive and negative symptoms
What did Pontillo et al.’s schizophrenia study into CBT find?
Reductions in frequency and severity of auditory hallucinations
Pontillo et al. (2016) found reductions in the frequency and severity of what as a result of CBT?
Auditory hallucinations
What does NICE stand for?
The National Institute for Health and Care Excellence
Clinical advice from NICE (2019) recommends what for schizophrenia?
CBT
The fact that clinical advice from NICE recommends CBT for schizophrenia means that…
clinical experience supports the benefits of CBT for schizophrenia
One limitation of CBT for schizophrenia is the wide range of what included in studies?
Techniques and sympto-ms
True/False: CBT techniques and schizophrenia symptoms vary widely from one case to another
True
What did Thomas (2015) point out about different studies into CBT for schizophrenia?
Different studies have involved the use of different CBT techniques and people with different combinations of positive and negative symptoms
Thomas (2015) points out that different studies have involved the use of what and who?
Different CBT techniques, people with different combinations of positive and negative symptoms
The overall modest benefits of CBT for schizophrenia probably conceal a wide variety of what?
Effects of different CBT techniques on different symptoms
The fact that the overall modest benefits of CBT for schizophrenia probably conceals a wide variety of effects of different CBT techniques on different symptoms makes it hard to say how effective CBT will be for what?
A particular person with schizophrenia
Although CBT may improve the quality of life for people with schizophrenia, it does not actually do what?
‘cure’ them
True/False: Schizophrenia appears to be largely biological
True
We would expect that psychological therapy like CBT just benefits people by improving their ability to live with schizophrenia, however…
studies report significant reductions in the severity of both positive and negative symptoms
The fact that studies report that CBT leads to significant reductions in the severity of both positive and negative symptoms of schizophrenia suggests that CBT does what?
More than enhance coping
